Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. SB 780
       
       
       
       
       
       
                                Ì753432ÅÎ753432                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RS            .                                
                  02/10/2016           .                                
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       The Committee on Governmental Oversight and Accountability
       (Hays) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 627.6442, Florida Statutes, is created
    6  to read:
    7         627.6442 Access to prescription drugs.—
    8         (1) As used in this section:
    9         (a) “Chronic illness” means human immunodeficiency virus
   10  infection, epilepsy, hypertension, or diabetes.
   11         (b) “Excluded drug” means a drug subject to restricted
   12  distribution by the United States Food and Drug Administration
   13  or a drug that requires special handling, provider coordination,
   14  or patient education and cannot be provided by a retail
   15  pharmacy.
   16         (2) A health insurance policy issued, delivered, or renewed
   17  in this state that provides major medical coverage and
   18  prescription drug coverage may not require an insured to obtain
   19  a prescription drug for the treatment of a chronic illness
   20  exclusively from a mail order pharmacy, unless the prescription
   21  drug is an excluded drug.
   22         (3) An insured who elects not to use a mail order pharmacy
   23  to obtain a prescription drug prescribed for the treatment of a
   24  chronic illness may not be required to pay a copayment or
   25  satisfy other conditions that are not imposed on an insured who
   26  uses a mail order pharmacy if the retail pharmacy used by the
   27  insured:
   28         (a) Agrees to the same terms and conditions, including
   29  credentialing, applicable to a mail order pharmacy; and
   30         (b) Accepts payment or reimbursement from the insurer which
   31  is no more than the amount that would be paid to a mail order
   32  pharmacy for the same prescription drugs for the treatment of a
   33  chronic illness.
   34         (4) A health insurer that issues a major medical policy
   35  that provides coverage for prescription drugs through a mail
   36  order pharmacy shall disclose in the outline of coverage that an
   37  insured may obtain prescription drugs for the treatment of a
   38  chronic illness from a retail pharmacy, and that the exclusive
   39  use of a mail order pharmacy is not required unless the drug is
   40  an excluded drug.
   41         (5) This section does not apply to grandfathered health
   42  plans as defined in s. 627.402, or to benefits set forth in s.
   43  627.6561(5)(b), (c), (d), and (e).
   44         Section 2. This act shall take effect January 1, 2017.
   45  
   46  ================= T I T L E  A M E N D M E N T ================
   47  And the title is amended as follows:
   48         Delete everything before the enacting clause
   49  and insert:
   50                        A bill to be entitled                      
   51         An act relating to the provision of pharmaceutical
   52         services; creating s. 627.6442, F.S.; defining terms;
   53         providing that an insured may not be required to
   54         obtain a prescription drug for the treatment of a
   55         chronic illness exclusively from a mail order
   56         pharmacy; providing an exception for excluded drugs;
   57         prohibiting the imposition of copayments or conditions
   58         on an insured living with a chronic illness if such
   59         copayments or conditions are not imposed on an insured
   60         who uses a mail order pharmacy that meets certain
   61         requirements; requiring certain health insurers to
   62         disclose in the outline of coverage that an insured
   63         may obtain certain prescription drugs from a retail
   64         pharmacy; providing an exception for excluded drugs;
   65         providing applicability; providing an effective date.